Pulmonary nodule tracking using chest computed tomography in a histoplasmosis endemic area ★★★

ObjectiveIn areas with endemic histoplasmosis, incidental pulmonary nodules are common. Rate of malignancy and applicability of current tracking guidelines in these regions remain unclear.MethodsA total of 148 cases of incidental pulmonary nodules tracked with chest computed tomography were reviewed for radiologic characteristics, diagnosis, number, and size.ResultsOf the nodules, 87.8% were benign and 12.2% malignant; 30% of nodules > 20 mm were malignant. Number of nodules (P= .14) and granulomatous disease (P= .71) were not related to malignant diagnosis.ConclusionMalignancy was lower than expected in nodules > 20 mm. Appropriate tracking guidelines for incidentally discovered nodules in histoplasmosis endemic regions must be determined.